A central venous catheter, also known as a central line, is a catheter placed into a large vein in the neck including the internal jugular vein or external jugular vein, in the chest including the subclavian vein, or in the groin including the femoral vein. A central line is used to administer medication or fluids, obtain blood tests, and/or directly obtain cardiovascular measurements such as the central venous pressure. Such catheters are designed for long-time use in the order of weeks, months and even years in order to avoid many needle punctures that may cause pain, fear, anxiety and/or risks of skin infections. For example, a cancer patient requires frequent blood tests or chemotherapy and thus typically has a surgically implanted catheter. During chemotherapy, a surgically implanted catheter permits subsequent patient care on an outpatient basis. The patient returns to a medical facility for administration of the therapeutic agent through the catheter without having a needle inserted into a vein each time. Moreover, an implanted catheter makes it possible for the patient or an attendant to perform certain other procedures at home thereby reducing the number of times the patient must leave his or her residence. This is particularly advantageous when the patient is a small child.
A Hickman® catheter is a specific type of long-term catheter that is generally flexible and is comprised of a small permanent rubber internal tubing portion that is surgically implanted into the right atrium of the heart, an external tubing portion extending from the exit site where the internal tubing portion extends from the patient's body, and an enlarged capped portion attached to the end of the external tubing portion. Such implants necessitate a surgical procedure normally under general anesthesia. Typically the internal tubing portion is inserted under the skin of the chest wall and into a large vein that leads into the heart. The external tubing must be secured to the patient, normally by padding and tape adhered to the skin, in order to assure that the patient does not dislodge the catheter by inadvertent manipulation of the catheter line. The external portion of the catheter has in prior practice been taped directly to the skin of the body with the capped end or ends positioned upwardly.
Securing the external portion of the catheter to the patient with tape to prevent displacement and/or dislodgment of the catheter has disadvantages. Most importantly, securement via tape may not sufficient hold the catheter tubing onto the patient. For example, when the patient is a small child, the child may play with or rip the tape away from the skin causing irritation and increasing the risk of infection. Sometimes a child will open the catheter line and suffer blood loss or permit air to enter into the bloodstream. Children have been known to dislodge the catheter itself or even pull it out thereby imposing a serious medical condition, sometimes requiring another surgical procedure under unfavorable, emergency conditions. As a result, medical personnel sometimes are reluctant to implant catheters in small children unless there is some assurance that the child will not play with the catheter thereby compounding the various risks normally associated with such implants. This generally means some assurance that the child will always be watched. Even when the patient is an adult, the tape may not afford the desired freedom of movement because the patient constantly may fear dislodgment of the catheter from its exit site on the body.
In addition, the tape used to secure the external portion of the catheter must be removed and replaced at least once a day. More particularly, each time the capped free end of the catheter is to be used, it is first necessary to remove the tape that secured the externally extending tubing portion to the body. Since the tube has to be flushed out at least once a day to prevent clogging, this means that the tape has to be removed at least once a day and often more for other required purposes. Frequent removal and replacement of the tape from the body generally results in sores and/or irritation to the body and thus, discomfort to the patient.
Garments for holding and/or storing catheters have evolved. These garments have lessened or eliminated many of the disadvantages inherent with the tape-retention method for the catheter tubes, but there is still a need in the art to develop and/or improve a garment that secures an external portion of a central line or catheter, especially for sensitive and/or special need patients such as children.